Mental Health: Who Pays for Which Services?
Mental stress is not a fringe issue in Switzerland. According to the Swiss Health Survey by the Federal Statistical Office, around 18 percent of the population aged 15 and over felt moderately or severely psychologically stressed in 2022, up from 15 percent five years earlier. Among 15 to 24-year-olds, the proportion is even higher. At the same time, available therapy slots are scarce in many places, and the question of who pays for which session is unclear to many. We show you what basic insurance covers, which costs you have to bear yourself, and how gaps can be closed.
What Basic Insurance Covers
In basic insurance, mental illnesses are generally treated equally to physical illnesses. Coverage includes treatment by a psychiatrist, psychological psychotherapy by approved specialists, medications on the specialty list, and inpatient treatments in the general ward of a hospital or clinic.
It is important to distinguish between psychiatry and psychological psychotherapy: Psychiatrists are medical doctors. Those with an insurance model allowing free choice of doctor can generally contact them directly. However, with GP, HMO, or other models with restricted doctor choice, the regulations of the respective model must be observed.
For psychological psychotherapy with a psychologist, a medical referral is always required for basic insurance to cover the costs. This referral is valid for a limited number of sessions and can be extended. For longer-term therapies, prior approval from the health insurance company is required.
Important to know: Covered does not mean free. Deductibles and co-payments also apply to psychiatric and psychotherapeutic treatments. Depending on the chosen deductible, adults pay the first 300 to 2,500 Swiss francs themselves, plus a 10 percent co-payment up to an annual maximum of 700 Swiss francs.
Where Costs Arise That You Bear Yourself
Various situations can lead to costs that insured individuals must bear themselves.
Waiting time for a therapy slot: A referral is of little use if no one has available appointments. This is often where access fails: A 2024 analysis of the largest Swiss directory of specialists showed that about one-third of psychologists were not accepting new clients at all, and for another third, the waiting time was at least four weeks. Those who cannot wait that long often resort to a practice that does not bill through insurance and pay themselves. Depending on the region and practice, an hour there costs between approximately 150 and 250 Swiss francs.
Consultation without a medical referral: Not every burden is a diagnosis. Those seeking support due to professional overload, a separation, or a difficult family situation do not always automatically receive a referral for it. Psychological counseling, coaching, and couples counseling are not covered by basic insurance and must be paid for entirely out of pocket.
Treatment by unapproved specialists: If a therapist does not meet the admission requirements, basic insurance will not cover the costs, even with a medical referral. A quick check of their accreditation before the first session can prevent surprises.
How to Close These Gaps
This is where outpatient supplementary insurance comes in. Depending on the provider and model, these contribute to psychotherapeutic treatments not covered by basic insurance, usually with a percentage of the costs and an annual maximum. The specific policy regulates how high this share is and for which specialists it applies.
In addition, low-threshold digital services have become established. Some outpatient supplementary insurance plans contribute to digital psychological counseling, often covering 75 percent of costs up to 1,000 Swiss francs per year, depending on the model. Access is available without a medical referral, and appointments are often available at short notice. However, this does not replace psychotherapy. As a first step, to bridge a waiting period, or for issues below the treatment threshold, it can be the right solution.
Check Before You Need It
Unlike basic insurance, supplementary insurance is subject to the Insurance Contract Act. There is no obligation to accept applicants, and the state of health is checked before conclusion. Therefore, anyone already undergoing treatment or with a diagnosis must expect a reservation or rejection. Depending on the insurance and service, a waiting period (qualifying period) may also apply, during which no claim for benefits exists. The exact conditions vary depending on the provider and product.
It is therefore worth checking your policy, even before a stressful phase. If you want to adjust your coverage, you should also be aware of the deadlines: For many supplementary insurance policies, cancellation is possible at the end of the year with three months’ notice, meaning the letter must arrive by September 30.
If You Need Someone Quickly
Regardless of any insurance questions, there are free contact points: Die Dargebotene Hand (The Helping Hand) can be reached 24/7 at 143, and Pro Juventute for children and young people at 147. Pro Mente Sana offers telephone counseling by specialists. In an acute emergency, dial 144. For starting therapy, your GP’s practice remains the most obvious first point of contact.
Whether your existing policies include benefits for mental health can often be clarified in a brief conversation. The advisors at simply will take the time to discuss this with you free of charge and without obligation, either in person in Gümligen or conveniently via video consultation.
Fact sheet on outpatient supplementary insurance 